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Payee NamePreparer TelephoneDate Prepared
Dept NamePrepared By
Address*StatusEmployeeSend Check to:
City, St, ZipStudent
Employee ID**
Other (list at right)
DateAmount
-$
DateAmount
-$
Date
FromTo
Total MilesParking & TollsAmount
-
-
-
-$
APPROVALS
-$
Employee/Payee
Signature*:
DateAccount
Project/Grant (if
required)
Amount
Supervisor (print name)-$
Supervisor Signature:Date
Dept Chair/Dean/VP:Date
BFO/Asst Dean:Date
SPA (grants):Date
Refer to the online Business Expense policy at:1/14
http://finance.tufts.edu/accpay/pid=4
-$
-$
LOCAL TRAVEL TOTAL
MEAL EXPENSES
Business Purpose of Meal
List Attendees
Type of Expense
Business Expense Reimbursement Form
Where held (restaurant, etc)
Business Purpose
OTHER BUSINESS EXPENSES
OTHER TOTAL
LOCAL AUTO MILEAGE & PARKING & TOLLS
.56/Mile
Business Purpose
Return completed form with proper approvals & original receipts to: Accounts Payable, TAB, Medford Campus
APPROVAL SIGNIFIES COMPLIANCE WITH UNIVERSITY POLICIES & PROCEDURES. IN ADDITION, IF GRANT FUNDED,
IN ACCORDANCE WITH FEDERAL COST PRINCIPLES AND SPONSORED AGREEMENT GUIDELINES, THERE ARE NO
UNALLOWABLE COSTS (I.E. ALCOHOL, ENTERTAINMENT ETC.) CHARGED TO GRANTS.